Quote: Original post by HostileExpanse

Quote: Original post by Eelco
The profit margins of insurance companies are less than 5% of invested captital per annum. You are better off putting your money in bonds. How can it then be the core of your cost problem?

Here's another fun fact:

Quote: This report looks at the 2003-2007 profits for the country’s major national health insurance companies (such as UnitedHealth Group and WellPoint), which sell health insurance through their subsidiaries. Over that period, their combined profits increased by 170.2 percent, reaching $12.6 billion at the end of 2007.

Wow, big numbers. Im scared.

Quote:
Or another:

Quote: These insurance companies reported spending an average of more than 18 percent
of their revenues on marketing, administration, and profits.

What of it?

Quote:
And more:

Quote: Health insurance premiums in states with better-than-average competition were 12 percent lower than those in states with worse-than-average competition, according to a University of Pittsburgh Medical Center study of 31 states.

So yeah, more competition is what we need.

Quote: Original post by Alpha_ProgDes

Quote: Original post by Oluseyi

Quote: Original post by BeanDog
Umm, isn't that trillion-dollar figure for the public option spread out over 10 years or something? The 2.4 trillion is every year.

That makes the public option look that much better, because it then declines to 0.939% of GDP annually, vs 17.34%.

Quote: Also, that trillion dollar figure is in addition to our existing healthcare costs. Sure, the idea is that it will redirect some of the money currently going to private insurance into a government-run program, but from what I can tell the $1.whatever trillion dollar cost is the loss the government is taking on the program.

I'm not sure about that. I have no figures either way, but my position is that I'm perfectly fine with healthcare not being revenue-neutral. We spend - lose - a lot more on defense projects, and the health of our population is something that we should be willing to invest less than 1% of our GDP in.

Quote: So basically, I have no idea what you're talking about.

"Public option cheaper than private."

I believe BeanDog was responding to Chris, not you.

Incorrect. I was responding to Oluseyi. Also, my post was policy-neutral; I don't know enough to honestly form an opinion on whether the public option as currently outlined will provide a good bang-for-the-buck vs. other options. I was just pointing out how silly these arguments over dollar amounts are when they're not normalized by time span.

My gut feeling, though, is that I'd prefer to see mandatory (via tax penalties/credits), subsidized private health insurance. In other words, I'd like to see them ditch any government-encouraged relationship between employment and health insurance. I'd rather the government give me a tax credit based on my family size (and possibly health conditions?) if I demonstrate ownership of private health insurance that meets government mandates on coverage levels. That way I could buy cheap catastrophic insurance and pocket the difference, or pay a little extra on my own for the gold-plated $20-copay plan.

It's kind of like the difference between building dedicated housing projects and subsidizing arbitrary housing. I'm afraid the "public option" insurance plan is going to turn into the ghetto of the health care industry in the US as it becomes over-regulated and under-funded. Subsidizing private insurance could be budgeted much more directly and, I would hope, more efficiently.

Original post by Eelco

Quote:
And more:

Quote: Health insurance premiums in states with better-than-average competition were 12 percent lower than those in states with worse-than-average competition, according to a University of Pittsburgh Medical Center study of 31 states.

So yeah, more competition is what we need.

Doesn't really work that way. Insurance companies work because they are a delayed-usage product. They get to advertise "Pay us this low price now, we promise we'll give it back when you need it wink wink nudge nudge 'know what I mean". Of course then it comes time to pay out their obligations, "whoops, sorry we hired these fancy lawyers and they decided that despite the fact that we promised to pay, we don't actually have to pay".

So you end up with 50 companies lowering their premium costs due to all the competition, and they're all whoring themselves out, advertising their lower costs, making it seem like competition has lowered costs, but then when it comes time to actually make payouts for the obligations they have they're going to cut every corner possible to provide the lowest payout they can get away with. Preferably $0 in their shareholders eyes.

How is that even remotely a good idea?

The market is only "efficient" when profit is the only factor to be considered. In the real world, there's more to life than just greed and profit.

Quote: Original post by HostileExpanse

Quote: Original post by Eelco

Quote: Original post by HostileExpanse
Here's another fun fact:

Quote: This report looks at the 2003-2007 profits for the country’s major national health insurance companies (such as UnitedHealth Group and WellPoint), which sell health insurance through their subsidiaries. Over that period, their combined profits increased by 170.2 percent, reaching $12.6 billion at the end of 2007.

Wow, big numbers. Im scared.

Do you have an intelligent response to those "big numbers"?

No he usually doesn't. This is what happens when you don't actually have logic and reason on your side.

^^

Ahh... I kinda got that feeling when the thread was on page 10 and he finally bothered to ask a couple of details on what was actually under consideration in the healthcare debate.

Quote: Original post by Eelco

Quote: Original post by HostileExpanse

And more:
Health insurance premiums in states with better-than-average competition were 12 percent lower than those in states with worse-than-average competition, according to a University of Pittsburgh Medical Center study of 31 states.

So yeah, more competition is what we need.

Heck yeah! Public option, here we come!

Quote: Original post by Eelco

Quote:
Or another:

Quote: These insurance companies reported spending an average of more than 18 percent
of their revenues on marketing, administration, and profits.

What of it?

Well, That's an 18% overhead that the public option won't have. Obviously admin has an overhead, but a non-profit option that would need a modest advertisement campaign* will run far more cheaply.

*really just a campaign at the start of its introduction to explain what it does and how to get it. After that it'd pretty much just be pamphlets in clinics and a few posters...

Quote: Original post by Eelco
Perhaps its you who should excuse yourself from the discussion, because none of that seems to relate to my comment. The profit margins of private insurers are not what makes american insurance expensive. Why dont you just admit it?

Regardless of the nobility of not denying people care, how anyone can believe that extending care by itself will bring down costs is beyond me.

My remarks pertained to your question about leeching. I'm going to restate an item from the links that you avoided. Challenge to Health Bill: Selling Reform

Quote:
...
The United States now devotes one-sixth of its economy to medicine. Divvy that up, and health care will cost the typical household roughly $15,000 this year, including the often-invisible contributions by employers. That is almost twice as much as two decades ago (adjusting for inflation). It’s about $6,500 more than in other rich countries, on average.
...

The leeches suck $6,500 from each household every year.

Where does that money go? Into some fat cat's pocket.

As for those holy profits you worship...

I seriously doubt you are familiar with the concept of medical loss ratio. That is an insurance industry term for the fraction of revenue from a plan's premiums that goes to pay for medical services. The fact that the term is seen as a loss says it all. Services provided aren't seen as a positive thing but as a negative thing. Those damn patients are spending our money!!!

Medical-loss ratios of largest for-profit insurers

Quote:
Medical-loss ratios for 2005 (Source: Company 10-K, year-end filings with the Securities and Exchange Commission):

76.9% - Aetna
82.3% - Cigna
83.9% - Health Net
83.2% - Humana
78.6% - UnitedHealth Group
80.6% - WellPoint

Bill Moyer's July 31, 2009

Quote:
...
BILL MOYERS: You told Congress that the industry has hijacked our health care system and turned it into a giant ATM for Wall Street. You said, "I saw how they confuse their customers and dump the sick, all so they can satisfy their Wall Street investors." How do they satisfy their Wall Street investors?

WENDELL POTTER: Well, there's a measure of profitability that investors look to, and it's called a medical loss ratio. And it's unique to the health insurance industry. And by medical loss ratio, I mean that it's a measure that tells investors or anyone else how much of a premium dollar is used by the insurance company to actually pay medical claims. And that has been shrinking, over the years, since the industry's been dominated by, or become dominated by for-profit insurance companies. Back in the early '90s, or back during the time that the Clinton plan was being debated, 95 cents out of every dollar was sent, you know, on average was used by the insurance companies to pay claims. Last year, it was down to just slightly above 80 percent.

So, investors want that to keep shrinking. And if they see that an insurance company has not done what they think meets their expectations with the medical loss ratio, they'll punish them. Investors will start leaving in droves.

I've seen a company stock price fall 20 percent in a single day, when it did not meet Wall Street's expectations with this medical loss ratio.
...

There you have it. The portion of the economy devoted to health care doubled at the same time that the medical loss ratio decreased. You would have to be willfully blind to not see the massive rip off in that. Either that or a criminal cheering on other criminals as they pillage and loot. Want to bring down costs? Start by doing away with the middle men sucking away 20 cents of every dollar spent on health insurance.

Quote: Original post by Winegums

Quote: Original post by Eelco

Quote:
Or another:

Quote: These insurance companies reported spending an average of more than 18 percent
of their revenues on marketing, administration, and profits.

What of it?

Well, That's an 18% overhead that the public option won't have. Obviously admin has an overhead, but a non-profit option that would need a modest advertisement campaign* will run far more cheaply.

To add to what you've said .... it wasn't so long ago that even private insurers once kept overhead at less than 5%, which is largely in line with what we know to be possible today in the US.


But, yeah... this is definitely an area where a public option would help to keep the corporations a heckuva lot more honest.






(edit: Oh... LessBread already beat me to the stats on overhead when private insurers were more competitive.)

Quote: Original post by Chris Reynolds

Quote: Original post by HostileExpanse

Quote: Original post by Chris Reynolds
2.) Regarding physicians all being paid the same:

(A) PREFERRED PHYSICIANS.—Those physicians who agree to accept the payment rate
established under section 223

PARTICIPATING, NON-PREFERRED
PHYSICIANS.—Those physicians who agree not
to impose charges (in relation to the payment
rate described in section 223 for such physicians) that exceed the ratio permitted under section 1848(g)(2)(C)

So all physicians that participate will be affected by this.

People will have to accept certain amounts for payment, AFTER they've agreed to accept payments on that basis for the year?!! OH THE HORROR!

Think of it this way. If you're a physician and this bill went into effect, you either agree to the payment terms, or you become a "non-preferred" "non-participating" physician. Which sounds better to you? Stuck between a rock and a hard place

So let's say I have something growing in my arm. It wasn't a big deal a few years ago. Then let's say I have tissue Doctor's wanted to cut out of my chest a few years ago. Then lets say I have asthma and it may be getting worse, or I may be coming down with something. An X-ray there is a given. I also could really, really use some of those fancy allergy shots I've always heard about. Let's also say I have Something going on with my stomach that effects my breathing but is likely just acid do to stress. Let's say I also have a wife with Diabetes. Heck we will also say she has a predisposition to cancer. We will leave it at that for now.

So now lets also say my "insurance" plan has gotten amended in the last couple of years. I now have to pay for every dime until I've paid $2500. Then they say they will pick up the remaining tab. Now I'm not sure if that thing in my arm could turn into a problem one day. I'm not real sure if the thing in my chest could either. My grandmother did die of stomach cancer and I have stomach issues so maybe I should watch that, but I don't really know when or if that will be an issue. My breathing situation could be better. I think its getting worse, but maybe I just need to be more hard core about my meds or get my dose upped. Maybe it has turned into emphysema but who knows.

Now I don't know how bad my pre-existing conditions are at this point. I'm not at Doctor. What I do know is that if I go see a Doctor I get to pay for it. Up to $2500 worth. That almost $200 a month that I do not have. My wife isn't even insured at all. Going unmonitored for a very serious disease right now. If it comes down between me paying $200 a month on something I'm not too sure about or me dying, I'm dying. I don't know what that thing in my arm is doing to me, I DO know what $200 dollars a month would do to me.

If you want talk about rocks in hard places, there is one. I personally don't have a whole lot of concern about some Doctor's right to maximize his paycheck. I really don't care what he makes but it better not be the reason I can't care for myself. Somebody better have a damn good alternative if they are going to sand in the way of trying to overhaul this thing. Because as it stands I don't get much of a choice and it could be killing me.